Iron Deficiency Anemia as Risk Factor for Thinning of Peripapillary Retinal Nerve Fiber Layer Thickness.

Abstract

peripapillary retinal nerve fiber layer thickness ,Iron deficiency anemia, spectral domain optical coherence tomography, Purpose:-To compare thickness of peripapillary retinal nerve fiber layer (RNFL) in adult females having iron deficiency anemia (IDA) with age matched healthy control females by using spectral domain optical coherence tomography (OCT). Materials and Methods:-The study was conducted upon 30 adult female patients who had IDA (hemoglobin <12 g/dl, serum iron <50 μg/dl mean corpuscular volume <80 fl/ red cell) and 30 age matched healthy control females .complete ophthalmic examination (assessment of refraction and best corrected visual acuity ,intraocular pressure (IOP) measurement by Goldmannapplanation tonometry and fundus examination with C/D ratio assessment).Measurement of peripapillary retinal nerve fiber layer thickness by spectral domain optical coherence tomography . Blood analysis for hemoglobin, serum iron and mean corpuscular volume. Results:-Mean age of 30 adult anemic female patients was 33.57 ± 7.48 (range, 20-47) years, and of 30 healthy control females was 33.77 ± 6.32 (range, 22-46) years (P = 0.87). The mean RNFL thickness in anemic female patients was 89.5 ± 2.014, and in healthy control females was 94.22 ± 1.486 (P = 0.000026). The mean of inferior quadrant RNFL thicknesses of anemic female patients was 118.83 ± 2.75, and in healthy control females was 124.47 ± 1.93 (P = 0.000032). The mean of superior quadrant RNFL thicknesses of anemic female patients was 109.83 ± 2.3, and in healthy control females was 114.47 ± 1.7 (P = 0.00043). The mean of nasal quadrant RNFL thicknesses of anemic female patients was 69.4 ± 1.81, and in healthy control females was 73.7 ± 1.7 (P = 0.000028). The mean of temporal quadrant RNFL thicknesses of anemic female patients was 59.93 ± 1.95, and in healthy control females was 64.3 ± 1.7 (P = 0.00053). There was positive correlation between mean RNFL thickness and hemoglobin (r1 = 0.537, p1=0.002) and iron (r 2= 0.328, p2=0.005). Conclusions:-There is statically significant reduction of the thickness of peripapillary RNFL thickness measured by OCT in adult female patients with IDA compared to healthy control females. It may have a great impact on assessment of many diseases as glaucoma and neuroophthalmological disorder.